Thoracic Spine Fractures with Blunt Aortic Injury: Incidence, Risk Factors, and Characteristics

Background: The coexistence of thoracic fractures and blunt aortic injury (BAI) is potentially catastrophic and easy to be missed in acute trauma settings. Data regarding patients with thoracic fractures complicated with BAI are limited. Methods: The authors conducted a prospective, observational, single-center study including patients with thoracic burst fractures. A multivariate logistic regression model was developed to determine the risk factors of aortic injury. Results: In total, 124 patients with burst fractures of the thoracic spine were included. The incidence of BAI was 11.3% (14/124) in patients with thoracic burst fractures. Among these patients, 11 patients with BAI were missed diagnoses. The main risk factors of BAI were as follows: Injury severity score (OR 1.184; 95% CI, 1.072–1.308; p = 0.001), mechanism of injury, such as crush (OR 10.474; 95% CI, 1.905–57.579; p = 0.007), flail chest (OR = 4.917; 95% CI, 1.122–21.545; p = 0.035), and neurological deficit (OR = 8.299; 95% CI, 0.999–68.933; p = 0.05). Conclusions: BAI (incidence 11.3%) is common in patients with burst fractures of the thoracic spine and is an easily missed diagnosis. We must maintain a high suspicion of injury for BAI when patients with thoracic burst fractures present with these high-risk factors.

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Sexual behaviour of inmates with Chlamydia trachomatis infection in the prisons of Catalonia, Spain

Sexual Health ◽

10.1071/sh11038 ◽

2012 ◽

Vol 9 (2) ◽

pp. 187 ◽

Cited By ~ 6

Author(s):

Evelin L. Corbeto ◽

Dolors Carnicer-Pont ◽

Rossie Lugo ◽

Victoria Gonzalez ◽

Elisabet Bascuñana ◽

...

Keyword(s):

Risk Factors ◽

Chlamydia Trachomatis ◽

High Mobility ◽

Cross Sectional Study ◽

Multivariate Logistic Regression Model ◽

Cross Sectional ◽

Convenience Sample ◽

Chlamydia Trachomatis Infection ◽

High Risk Factors ◽

Independent Risk Factors

Objective To determine the prevalence of Chlamydia trachomatis (CT) and high risk factors for acquisition in preventive prisoners in Catalonia. Methods: Cross-sectional study of a convenience sample of 478 prisoners aged between 18 and 35 years was analysed using real-time polymerase chain reaction. A standardized questionnaire was used to collect behavioural data. Significant differences were analysed in the descriptive study using Pearson’s χ2. The association between CT and its determinants was analysed using the Mantel–Haenszel test and a multivariate logistic regression model. Results: The overall prevalence of CT was 5.4%. The independent risk factors for infection by CT were as follows: foreign origin, having had concurrent sexual partners, and alcohol consumption. Conclusions: This is the first study performed in prisons of Catalonia that shows the prevalence of CT in young prisoners. The high mobility of young detainees could explain the similarity in prevalence obtained about young people in Catalonia. Systematic monitoring of CT infection in young preventive prisoners is important in order to prevent further problems in themselves and in the general population, since they become a ‘bridge population’ in sexually transmissible infection spreading.

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Μεσοπρόθεσμα και μακροπρόθεσμα αποτελέσματα της τοποθέτησης ενδαγγειακών προθέσεων στη θωρακική αορτή

10.12681/eadd/37893 ◽

2014 ◽

Author(s):

Κωνσταντίνος Σπηλιωτόπουλος

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Injury Severity Score ◽

Injury Severity ◽

Aortic Injury ◽

Technical Success ◽

Stent Grafts ◽

Blunt Thoracic Aortic Injury ◽

Thoracic Aortic Injury

Objective: Surveillance for patients undergoing Thoracic Endovascular AorticRepair (TEVAR) for Blunt Thoracic Aortic Injury (BTAI) varies. Empiricalrecommendation of annual chest CTA is often suggested. Concerns over risks andcosts have emerged. Evaluation of optimal follow-up frequency is attempted,based on 11-years outcomes and surveillance experience.Methods: 76 patients with BTAI received TEVAR from May 2002 to July 2013.Demographics, cardiovascular risk factors and Injury Severity Score (ISS), types,sizes, timing and outcomes of stent-grafts were retrospectively collected.Results: Mean age: 39.7 years (17-85), 8 (11%) females. Mean ISS: 46.2+/-18.5(deceased: 61.0+/-19.2, surviving: 44.2+/-17.6, p=0.023). Technical success: 71(93.4%). Mortality, all-cause: 7 (9.2%), of which, one (1.3%) was procedurerelated.Lost in follow-up: 6 (8%). To examine the effect of surveillance frequencyon outcomes, after excluding the 2 most recent (<1 year) surviving patients, wearbitrarily divided the remaining 61, with stable repairs, on the basis of theirfollow-up timing; 36: timely (+/- 6 months annual due visit) follow-up (clinical,CTA/MRA/echocardiogram). 25: delayed (>6 months annual due visit). Nosignificant differences found on survival, graft-related complications, need for reintervention,except from persistent hypertension, higher in 1st group. Allsurviving patients: excellent outcomes, no CVAs, paraplegia/paraparesis, medianfollow-up, both groups: 3 years (IQR 2.0-3.5, 1.5-5.4 years).Conclusions: Mid-term outcomes of TEVAR for BTAI patients with stable repairare excellent, both with timely (1.0-1.5 years) and delayed (>1.5 years) follow-upintervals at a median surveillance of 3 years. A larger prospective randomizedstudy could lead to a more relaxed, but equally safe surveillance schedule forthese patients, lowering both risks and costs.

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Risk Factors Associated with Venous Thromboembolism in Isolated Blunt Chest Trauma

The American Surgeon ◽

10.1177/000313481307900526 ◽

2013 ◽

Vol 79 (5) ◽

pp. 502-505 ◽

Cited By ~ 3

Author(s):

Steven A. Kahn ◽

Heidi Schubmehl ◽

Nicole A. Stassen ◽

Ayodele Sangosanya ◽

Julius D. Cheng ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Venous Thromboembolism ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Injury Severity ◽

Aortic Injury ◽

Chest Injury ◽

Hospital Length Of Stay ◽

Thoracic Injury

Isolated chest trauma is not historically considered to be a major risk factor for venous thromboembolism (VTE). After blunt chest trauma, VTE may be underappreciated because pain, immobility, and inadequate prophylaxis as a result of hemorrhage risk may all increase the risk of VTE. This investigation determines the predictors and rate of VTE after isolated blunt chest trauma. A review of patients admitted to a Level I trauma center with chest trauma between 2007 and 2009 was performed. Demographics, injuries, VTE occurrence, prophylaxis, comorbidities, Injury Severity Score, intensive care unit/hospital length of stay, chest tube, and mechanical ventilation use were recorded. VTE rate was compared between those with isolated chest injury and those with chest injury plus extrathoracic injury. Predictors of VTE were determined with regression analysis. Three hundred seventy patients had isolated chest trauma. The incidence of VTE was 5.4 per cent (n = 20). The VTE rate in those with chest injury plus extrathoracic injury was not significantly different, 4.8 per cent (n = 56 of 1140, P = 0.58). Independent risk factors for VTE after isolated chest trauma were aortic injury ( P < 0.01, odds ratio [OR], 47.7), mechanical ventilation ( P < 0.01; OR, 6.8), more than seven rib fractures ( P < 0.01; OR, 6.1), hemothorax ( P < 0.05; OR, 3.9), hypercoagulable state ( P < 0.05; OR, 6.3), and age older than 65 years ( P < 0.05; OR, 1.03). Patients with the risk factors mentioned are at risk for VTE despite only having thoracic injury and might benefit from more aggressive surveillance and prophylaxis.

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Blunt aortic injury: risk factors and impact of surgical approaches

Surgery Today ◽

10.1007/s00595-015-1152-0 ◽

2015 ◽

Vol 46 (2) ◽

pp. 188-196 ◽

Cited By ~ 8

Author(s):

Chien-Chao Lin ◽

Kuo-Sheng Liu ◽

Huan-Wu Chen ◽

Yao-Kuang Huang ◽

Jaw-Ji Chu ◽

...

Keyword(s):

Risk Factors ◽

Injury Risk ◽

Aortic Injury ◽

Surgical Approaches ◽

Blunt Aortic Injury ◽

Injury Risk Factors

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Abstract #803815: Prevalence of Gestational Diabetes Mellitus in Women with High Risk Factors at a Tertiary Care Hospital in North India

Endocrine Practice ◽

10.1016/s1530-891x(20)39556-2 ◽

2020 ◽

Vol 26 ◽

pp. 109-110

Author(s):

Smiti Nanda

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

High Risk ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

North India ◽

Care Hospital ◽

High Risk Factors

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High risk factors for fetal development

Public health of the Far East Peer-reviewed scientific and practical journal ◽

10.33454/1728-1261-2020-2-59-65 ◽

2020 ◽

pp. 59-65

Author(s):

Z.V. Sirotina ◽

◽

V.N. Sokolov ◽

Keyword(s):

Risk Factors ◽

High Risk ◽

Fetal Development ◽

High Risk Factors

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Screening strategy and time points for newborn hearing re-screening with high risk factors

World Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.1016/j.wjorl.2020.09.002 ◽

2021 ◽

Author(s):

Qingxiang Zeng ◽

Renzhong Luo ◽

Shengbao Yan ◽

Yiquan Tang ◽

Ruijin Wen ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Screening Strategy ◽

Time Points ◽

High Risk Factors ◽

Newborn Hearing

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Clinical characteristics and factors related to antibiotic-associated diarrhea in elderly patients with pneumonia: a retrospective cohort study

BMC Geriatrics ◽

10.1186/s12877-021-02267-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yoko Takedani ◽

Tsukasa Nakamura ◽

Noriko Fukiwake ◽

Toshihiro Imada ◽

Junji Mashino ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Elderly Patients ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tertiary Care ◽

Multivariate Logistic Regression Model ◽

Care Hospital ◽

Antibiotic Associated Diarrhea ◽

Elderly Inpatients

Abstract Background Antibiotic-associated diarrhea (AAD) is a common problem among elderly inpatients because many elderly patients are admitted for pneumonia or other conditions that necessitate antibiotic treatment. In the super aging population, more patients are suffering from pneumonia than before, but the incidence or risk factors for AAD among many elderly patients have not been well scrutinized. Methods We conducted a retrospective cohort study of elderly patients diagnosed with pneumonia from April 2014 to March 2019 who were admitted to the Department of General Medicine of a Tertiary Care Hospital in Japan. Patients (≥ 65 years of age) who were diagnosed with bacterial pneumonia or aspiration pneumonia and treated with antibiotics were included. We defined AAD by diarrhea with more than three loose or watery stools per day and included patients who had these symptoms for either one day or two or more consecutive days. We also assessed the length of hospital stay and in-hospital mortality. The potential risk factors for AAD included age, sex, body weight, body mass index, smoking, alcohol, activities of daily living (ADL),　comorbidities, vital signs, laboratories, the severity of pneumonia, antibiotic and other medication use. Results There were 1,067 patients, the mean age was 83 years, and men accounted for 59 %. β-Lactamase inhibitors were frequently prescribed antibiotics in 703 patients (66 %), and proton pump inhibitors (PPIs) were also commonly administered (48 %). AAD developed in 322 patients (30 %). The multivariate logistic regression model showed that β-lactamase inhibitors (OR 1.43, 95 % CI 1.05–1.95) and PPIs (OR 1.37, 95 % CI 1.03–1.83) were associated with AAD as well as age (OR 1.03 per year, 95 % CI 1.01–1.05). Conclusions AAD was common among elderly inpatients with pneumonia, and β-lactamase inhibitors and PPIs were associated with AAD. Strict use of such medication should be considered to decrease the risk of AAD.

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